title: Laparoscopic versus robotic rectal resection for rectal cancer in a veteran population.
abstract: BACKGROUND
  Robotic rectal cancer resection remains controversial. We compared the safety and efficacy of laparoscopic vs robotic rectal cancer resection in a high-risk Veterans Health Administration population.
  
  
  METHODS
  Patients who underwent minimally invasive rectal cancer resection were identified from an institutional colorectal cancer database. Baseline characteristics and outcomes were compared between robotic and laparoscopic groups.
  
  
  RESULTS
  The robotic group (n = 13) did not differ significantly from the laparoscopic group (n = 59) with respect to baseline characteristics except for a higher rate of previous abdominal surgery. Robotic patients had significantly lower tumors, more advanced disease, a higher rate of preoperative chemoradiation, and were more likely to undergo abdominoperineal resection. Robotic rectal resection was associated with longer operative time. There were no differences in blood loss, conversion rates, postoperative morbidity, lymph nodes harvested, margin positivity, or specimen quality between groups.
  
  
  CONCLUSIONS
  The robotic approach for rectal cancer resection is safe with similar postoperative and oncologic outcomes compared with laparoscopy.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Ramiro
authors.initials: R
authors.lastname: Fernandez
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Anaya
authors.forename: Linda T
authors.initials: LT
authors.lastname: Li
authors.forename: Sonia T
authors.initials: ST
authors.lastname: Orcutt
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Balentine
authors.forename: Samir A
authors.initials: SA
authors.lastname: Awad
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Albo
authors.forename: Avo
authors.initials: A
authors.lastname: Artinyan
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D020360:Neoadjuvant Therapy; D061646:Operative Time; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D013781:Texas; D014728:Veterans
keywords: Rectal cancer; Rectal resection; Robotic surgery